Jornada de trabalho prolongada no setor saúde do município de Belo Horizonte

Abstract

Health personnel are protagonists in developing and improving the health system, for caring of individuals and their communities, helping to improve the quality of life and health of the population. Thus, they occupy a key position in society. In recent years, health personnel have been fighting to reduce their working hours. This occupational group is exposed to long working hours, due to the need for continuous operation of health institutions, 24 hours a day, every day of the week. Long working hours are a major risk factor for acute and chronic health problems. The aim of this study were: 1) To analyze the occurrence of weekly long working hours of the Municipal Health Department of Belo Horizonte (SMSA-BH); 2) To identify the proportion of workers exposed to weekly long working hours according to the self-report; 3) To identify the individual and employment characteristics associated with long working hours. A survey was conducted with SMSA-BH workers in 2009. The selection of participants followed the stratified random sampling and proportionate based on: geographic area, level of complexity of care (health centers, ambulatory specialties, emergency units or district management) and occupation. To collect the information we used a selfadministered questionnaire addressing issues on health and work of health personnel. The size of the proportional sample was of 1.549 subjects from a total of 13.602 workers. The occurrence was evaluated according to self-report of long working hours. The magnitude of the associations was estimated by means of Poisson regression, in univariate and multivariate models. The rate of occurrence of long working hours was 31.4%. Positive associations were found with male sex (PR 1.34, 95% CI 1.16-1.56), workers with children (PR 1.32, 95% CI 1.12-1.54) and occupations that provide healthcare services, that is, between those who are directly in connection with the SUS users (PR 1.50, 95% CI 1.25-1.79). Negative associations were observed with high school, technical and uncompleted undergraduate educational levels (PR 0.73, 95% CI 0.62-0.86) and elementary educational level (PR 0.47, 95% CI 0.31-0.70). Over 30% of respondents reported working more than 44 hours per week. Over 40% of Brazilian workers work more than the legal 44 hours per week. In the world, about one in five workers are exposed to working hours exceeding 48 hours per week. A higher occurrence of long working hours in males compared to females was observed, being such result convergent. Having children also influences the duration of the working hours, and this effect varies according to sex: for men, it increases the duration of paid working hours; for women, the effect is a decrease in paid working hours. Shorter working hours predominated in the group of individuals with less education, which is a statistically significant result. It is plausible to suppose that the nature of the tasks of the most educated in the health sector explains this result, because in this group are concentrated workers (healthcare providers) that practice a direct assistance to users. The association between the subgroup "healthcare providers" and long working hours was not surprising. Besides the nature of the tasks that leads to a typical temporal organization, for this subgroup, the multirole is possible. The results confirm the importance of individual variables in explaining the long working hours and raise approaches about the nature of the tasks according to the occupation.